William E. Randall, Jr., M.D. P.a.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

D0015808 Issued in MD

Legal business name

WILLIAM E. RANDALL, JR., M.D. P.A.

Practice address

1205 York Rd
Suite 33
Lutherville, MD 21093-6210

Phone

(410) 823-1313

Fax

(410) 823-1316

NPI assigned

Nov 5, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William Eddy Randall Jr., M.D.

Title

Owner

Phone

(410) 823-1313

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263081600000",
    "number": "1194052555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "SUITE 33",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-823-1313",
            "fax_number": "410-823-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD",
            "address_2": "SUITE 33",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936210",
            "telephone_number": "410-823-1313",
            "fax_number": "410-823-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM E. RANDALL, JR., M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2010-01-10",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-823-1313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D0015808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "06372",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "34794001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4070033",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BS",
            "identifier": "E181",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003951900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "443218",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Pulmonary Disease Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.